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Biomedical subjects

D Querleu

Publications and source records attributed to D Querleu.

At least 109 records · Page 6Linked to original sources
PubMed1995

Fluorescence of experimental endometriosis in rabbits, using tamoxifen-eosin association.

A major problem with endometriosis is the detection of microscopic and atypical lesions. An incomplete surgical eradication may lead to recurrence of the disease. This study aimed to investigate the diagnostic improvement of endometriosis by the use of tamoxifen-eosin induced fluorescence. The experimental study was performed on surgically induced endometriosis in the rabbit. Endometriosis was induced by grafting endometrium onto the broad ligament in 10 rabbits. After 5 weeks, the fluorescence of excised endometriosis was studied after systemic injection of tamoxifen and local application of eosin. Healthy peritoneal samples served as controls. The fluorescence of endometriotic foci was also compared with (n = 5) or without (n = 5) tamoxifen. Fluorescence excitation was carried out using a 150 W filtered lamp connected to an optical fibre. Fluorescence emission was measured using an optical fibre connected to a spectrofluorometer. Spectral analysis showed a specific fluorescence of endometriosis 72 h after systemic injection of tamoxifen and eosin application. This result is explained by binding to oestrogen receptors of tamoxifen which was protonized to form an ionic pair with eosin. Histological study of samples from the graft of endometrial tissue showed that experimental endometriosis had developed in eight out of the 10 rabbits. However, the fluorescence was not significantly different among the 10 rabbits. This observation was in accordance with previous studies in which endometriosis was confirmed by routine histological techniques or electron microscopy in 70-80% of cases. Consequently, the fluorescence of the two samples which did not present histological evidence of endometriosis indicates the presence of microscopic endometriotic foci.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

Moderate prenatal alcohol exposure and psychomotor development at preschool age.

OBJECTIVES: This study investigated the effect of moderate prenatal alcohol exposure on psychomotor development of preschool-age children in a longitudinal study. METHODS: Pregnant women were interviewed about their alcohol consumption at their first visit to the maternity hospital in Roubaix, France. Alcohol consumption before pregnancy and during the first trimester was assessed with a structured questionnaire. The psychomotor development of 155 children of these women was assessed with the McCarthy scales of children's abilities when the children were about 4 1/2 years old. RESULTS: Consumption of 1.5 oz of absolute alcohol (approximately three drinks) or more per day during pregnancy was significantly related to a decrease of 7 points in the mean score on the general cognitive index of the McCarthy scales, after gender, birth order, maternal education, score for family stimulation, family status, maternal employment, child's age at examination, and examiner were controlled for. CONCLUSIONS: This study showed that moderate to heavy alcohol consumption during pregnancy, at levels well below those associated with fetal alcohol syndrome, has effects on children's psychomotor development.

Adult↗
PubMed1995

Complications of gynecologic laparoscopic surgery.

The growing impact of laparoscopic surgery must not make us underestimate the existence of complications, some of them severe, with medical-legal implications. Several surveys and case reports of complications following modern gynecologic laparoscopic surgery, some reporting laparoscopic management of visceral injuries, have been published recently. The complication rate depends on the complexity of the surgical procedure; serious complications still arise during performance of laparoscopy. Patients must be informed of the hazards of so-called 'minimally' invasive surgery.

Female↗
PubMed1995

[Pelvic pain and external endometriosis. Physiopathology and treatment].

New data on the pathophysiology of pain associated with endometriosis are available. The predominant role of deep endometriosis has been stressed. In multivariate analysis, superficial endometriosis and even adhesions and ovarian cysts do not appear to be related with pain. Deep endometriosis is usually located posterior to the vagina and cervix, involving the pouch of Douglas, the rectovaginal septum and the uterosacral ligaments. In such cases, pelvic examination shows a painful induration or a nodule in this area. The anterior cul-de-sac and the lateral pelvic wall may also be involved. Two histological and clinical aspects may be observed: deep endometriosis arising under the peritoneal surface, or adenomyosis arising from the uterine cervix. Only complete surgical excision may be curative, but recurrences may occur after surgery. Hormonal therapy is only suspensive. However, surgical therapy involves a significant risk of complication. Surgery for deep endometriosis may be one of the most difficult gynecologic operations. It should be performed only by experienced surgeons, with skills in oncological dissections of the pelvis. The guidelines for therapy are thus clear. Superficial endometriosis does not cause pain and should not be treated by itself; symptomatic relief of pain may be obtained by therapeutic amenorrhea or by the placebo effect of surgery. Endometriomas are managed in the same way as all organic ovarian cysts. Adhesions are lysed if infertility is associated with pain, or to gain access to the retroperitoneal area. Etiologic therapy is acceptable only in case of deep endometriosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Endometriosis↗
PubMed1994

Laparoscopic surgical therapy and staging in a case of early malignant granulosa cell tumor of the ovary.

An early right granulosa cell tumor was removed without rupture through the vaginal route after laparoscopic division of the ovarian ligament. Staging biopsies, peritoneal cytology, infracolic omentectomy, pelvic and right infrarenal para-aortic dissection were completed laparoscopically. The patient was discharged on the third day, and she is doing well 22 months postoperatively.

Dermoid Cyst↗
PubMed1994

Laparoscopic infrarenal paraaortic lymph node dissection for restaging of carcinoma of the ovary or fallopian tube.

BACKGROUND: The purpose of the study was to investigate the feasibility of laparoscopic paraaortic lymphadenectomy in the restaging of ovarian carcinomas. METHODS: Nine patients in a referral center seen initially with ovarian (eight patients) or tubal (one patient) carcinoma who had experienced substandard staging during a previous laparotomy or laparoscopy underwent laparoscopic paraaortic lymphadenectomy as part of a surgical staging procedure that included peritoneal fluid sampling and multiple staging biopsies. Omentectomy, appendectomy, pelvic lymphadenectomy, contralateral salpingo-oophorectomy, salpingectomy, or laparoscopically assisted total vaginal hysterectomy was performed during the same operative session when necessary. RESULTS: All nine lymphadenectomies up to the level of the renal veins were successfully completed. The postoperative periods were uneventful, with an average postoperative stay of 2.8 days. CONCLUSIONS: Laparoscopic surgery may be an acceptable procedure for paraaortic lymph node sampling, sparing the patient a restaging laparotomy.

Adult↗
PubMed1994

The Impact of Laparoscopic Surgery on Vaginal Hysterectomy

The development of laparoscopic surgery may be used either to replace (laparoscopic hysterectomy, LH) or to extend the indications (laparoscopically assisted vaginal hysterectomy, LAVH) of the vaginal route. A 2-year (March 1991-March 1993) prospective study of the impact of laparoscopic surgery has been carried out by a group of surgeons experienced in both vaginal and laparoscopic surgery. The design of the study protocol was as follows: use the vaginal route whenever possible; select LH in women with very narrow vaginal access or LAVH to improve the feasibility and safety of vaginal hysterectomy in case of adnexal disease; and select laparotomy only when both laparoscopic and vaginal surgery are impossible. Women with genital prolapse or pelvic relaxation were excluded as well as women with invasive malignant disease of the genital tract. Four hundred twenty-eight patients were included. Abdominal hysterectomy was used in only 44 cases (10.3%), including 4 cases of failure of the vaginal technique. Vaginal hysterectomy was completed without laparoscopic assistance in 339 (79.2%) of cases. LAVH was performed in 45 cases (10.5%), LH in 0. Laparoscopic surgery is an efficient modality for the vaginal surgeon in the presence of adnexal disease, but does not replace the less expensive, quicker and probably safer vaginal hysterectomy.

Journal Article↗
PubMed1994

[Unexpected outcome of a twin transfusion syndrome. A case report].

A monochorial biamniotic twin pregnancy was uneventful until 24-weeks amenorrhoea when severe donor-recipient transfusion syndrome occurred. Unexpectedly, the situation stabilised spontaneously with regression of amniotic fluid anomalies. Pathology examination of the placenta revealed that a central placental cotyledon had undergone ischaemic necrosis which could have led to interruption of fetal-fetal transfusion at about 23 weeks amenorrhoea.

Adult↗
PubMed1994

[Place of celiosurgery in the extensive diagnosis of gynecologic cancers].

Laparoscopic surgery occupies an increasingly important place in the diagnosis and staging of gynaecological cancers. It allows repeated complete investigation of the abdomen and retroperitoneum: macroscopic examination of the peritoneum, cytology, biopsies, infracolonic omentectomy, appendicectomy, pelvic and para-aortic lymphadenectomy, without interfering with therapeutic procedures (simple or radical hysterectomy) which can be associated. In cancers of the endometrium, it is part of a surgical strategy associating vaginal hysterectomy. In ovarian cancers, it is essentially applied to restaging of insufficiently explored apparent stage I tumours. In operable cervical cancer, it guides the therapeutic protocol and surgical indication by allowing interiliac lymphadenectomy. In advanced cervical cancers, it is used to detect para-aortic lymph nodes.

Endometrial Neoplasms↗
PubMed1994

[Delay of the formation of retroperitoneal fibrosis after lymphadenectomy. An experimental study].

The goal of our study was to evaluate peritoneal and retroperitoneal healing and therefore to assess the optimal date for surgery after laparoscopic lymphadenectomy. A para-aortic lymphadenectomy was carried out in 5 groups of 5 New Zealand female rabbits. The perivascular cicatricial tissue was dissected after specific delay for each group (48 hours, 1 week, 2 weeks, 4 weeks, and 6 weeks). Peritoneal reconstruction was observed in 80% of the "48 h" group, and in 100% in the other groups (from 1 to 6 weeks). Vascular injury complicated dissection in 40% for the "1 week" group, in 80% for the "2 weeks" group, and in 20% for the "6 weeks" group. No vascular complication was observed in the "48 h" and "4 weeks" groups. The results of "1 week" and "2 weeks" were combined. The results of the "4 weeks" group were compared, with the Fisher test, to the results of a "1 week" and "2 weeks" combined group as well as to the results of the "six weeks" group. Four weeks seem to be the optimal date for a possible surgical excision after a laparoscopic lymphadenectomy.

Adipose Tissue↗
PubMed1994

[The "hazards" of using a Gore-Tex sling in the treatment of stress urinary incontinence].

OBJECTIVE: To analyze the use of the Gore-Tex in the treatment of exertion incontinence. METHODS: During 1991, two gynecology units used the Mouchel technique and a Goebell-Stoeckel type technique in 72 patients with exertion incontinence, alone in 36 and in combination with a cure for prolapsus in 36 others. Results were analyzed with the chi 2 squared test and the Student's test for paired series. RESULTS: The rate of incontinence was 65% with a range from 60 to 66.7% according to the type of technique used and whether a cure for prolapsus was also performed. Gore-Tex was not well tolerated in 23/72 cases. Rejection was seen in 20 to 37.5% according to the type of vaginal suture and the type of protection. CONCLUSION: The high rate of rejection suggests prudence in using Gore-Tex.

Adult↗
PubMed1993

Laparoscopic paraaortic node sampling in gynecologic oncology: a preliminary experience.

Because of the poor accuracy of nonsurgical methods in the detection of occult paraaortic lymph node metastasis, and because of the cost and discomfort of surgical staging, the feasibility of selective or elective paraaortic lymphadenectomy has been investigated in a preliminary series of four cases. Selective sampling of the lower paraaortic nodes in two cases of cervical carcinoma and of the infrarenal paraaortic nodes in two cases of early ovarian carcinomas were successfully completed by laparoscopy. The potential application of this new technique are discussed.

Adult↗